Definition and Overview
Paediatric audiology refers to a branch of science that deals with ear-related problems, specifically balance disorders and hearing loss that affect infants and children. Pediatrics covers neonates, toddlers, and children who are up to 12 years old, though many doctors these days extend their services to teens and young adults until 21 years old.
Audiologists are often compared with otolaryngologist (ENT) who specializes in ears, nose, and throat. But there are several major differences. The coverage of ENT specialists, for example, is varied and wide, as it tackles more complex ear issues, aside from conditions that affect the nose and throat. These medical professionals spend many years of in-depth medical training starting with four years of undergraduate school and another four years in medical school. They also spend at least three years to complete a residency program, while others proceed to complete a fellowship.
Audiologists are often considered as “hearing doctors” since their main specialty is the assessment, diagnosis, treatment, and management of different kinds of hearing losses, which may develop for a number of reasons. Further, since the ears also help in achieving balance, audiologists are also trained to handle balance disorders.
As for training, they normally take an audiology course in universities. However, in a number of states, before they can practice their profession, they need to obtain a doctor’s degree in audiology. They also need to spend at least 75 hours of post-university study. The audiologists are licensed in and regulated by the state where they wish to practice their profession.
When to See a Paediatric Audiologist
A child who has been diagnosed with a hearing problem or is suspected to have one, needs to see a paediatric audiologist.
The ear is divided into three sections, namely, outer, middle, and inner ear. The sound travels from the external or outer ear via the canal until it reaches the eardrum. Next to the eardrum is the middle ear composed of three very small bones that amplify the sound before it moves into the cochlea and the inner ear. The cochlea helps convert the sound into electrical signals that can be interpreted by the brain. Meanwhile, in the inner ear, is a fluid that is responsible for achieving balance. This prevents a child from feeling dizzy, among others, when standing or doing other movements.
A child, nevertheless, can develop hearing loss and balance problems for different reasons. These include infection, congenital defect, and even injury. He or she may also acquire any of the three different kinds of hearing problems.
The first one is called conductive hearing loss, which involves the decreased level of sound as it travels toward the inner ear. Some of the most common causes are external otitis, otitis externa (swimmer’s ear), otitis media (infection of the ear), or buildup of fluid in the middle ear due to a cold infection. The presence of a foreign body or deformity in the outer and middle ears can also cause this type of hearing loss.
The sensorineural hearing loss is characterized by inner ear damage, particularly in the cochlea or the nerves. Causes can range from head trauma, illnesses, and aging. The inner ear may also be damaged as a side effect of certain medications and heredity.
When a child exhibits both types of hearing loss, it is referred to as mixed.
A child may also develop balance disorders such as acoustic neuroma, which occurs when there’s a benign tumor that presses itself to the nerves responsible for balance and hearing, and Meniere’s disease, which affects the labyrinth of the inner ear. The labyrinth holds a membrane with endolymph fluid that helps achieve balance.
A paediatric audiology performs a series of exams to properly diagnose hearing and balance disorders. These are:
- Word recognition exam where the patient is asked to repeat the words that have been spoken by the audiologist
- Pure-tone test where a child presses a button that corresponds to certain tones, which are presented through the audiometer in different loudness and pitch
- Tympanometry, which is used to test the effectiveness of the eardrum using a small probe that places a small pressure to the organ
Depending on the results of the assessment, the audiologist then:
- Recommends a hearing device such as a cochlear implant to improve, restore, or gain hearing
- Tracks the progress of the disease or condition
- Refers the patient to other specialists such as an otolaryngologist or surgeon
- Provides recommendations on how to improve or manage the condition
- Counsels patients and families
Offers other treatments and therapies to help the patient cope with the condition
Haddad J Jr. Hearing loss. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 629.
O'Handley JG, Tobin E, Shah AR. Otorhinolaryngology. In: Rakel RE, ed. Textbook of Family Medicine. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 19.